Research Publications (Health Sciences)
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Item Motion palpation used as a postmanipulation assessment tool for monitoring end-feel improvement : a randomized controlled trial of test responsiveness(Elsevier BV, 2009-09) Lakhani, Ekta; Nook, Brian; Haas, Mitchell; Docrat, AadilA tenet of motion palpation theory is the ability to confirm postadjustive segmental end-feel improvement (EFI). Only one previous trial has evaluated the responsiveness of EFI; this was a study of the thoracic spine. The purpose of this study was to evaluate the responsiveness of postadjustive end-feel for evaluating improvement in putative segmental spinal motion restriction after spinal manipulative therapy (SMT) of the cervical spine.Methods
A prospective, blinded, randomized placebo-controlled pilot trial was conducted with 20 symptomatic and 10 asymptomatic participants recruited from a chiropractic teaching clinic. The treatment group received SMT, and the control group received placebo detuned ultrasound. Responsiveness was evaluated as the etiologic fraction (% of cases with EFI attributable to SMT) and as the sensitivity and specificity of change.Results
For the entire sample, the etiologic fraction was 63% (P = .002), sensitivity was 93%, and specificity was 67%. For symptomatic participants, a strong relationship appeared to exist between receiving SMT and EFI (etiologic fraction = 78%, P = .006; sensitivity = 90%; specificity = 80%). A strong relationship was not found for asymptomatic participants (etiologic fraction = 40%, P = .444; sensitivity = 100%; specificity = 40%), where EFI was recorded frequently, whether participants received SMT or detuned ultrasound.Conclusion
The findings of this study showed that motion palpation of end-feel assessment appears to be a responsive postmanipulation assessment tool in the cervical spine for determining whether perceived motion restriction found before treatment improves after SMT. This observation may be limited to symptomatic participants.Item Are point-of-decision prompts in a sports science and medicine centre effective in changing the prevalence of stair usage? : a preliminary study(2009) Pillay, Julian David; Kolbe-Alexander, Tracy; Achmat, Masturah; Carstens, Madelaine; Lambert, Estelle V.Objective. To determine the impact of a signed intervention on promoting stair versus lift usage in a health and fitness facility. Design. A 3-week observational study in which a simple timeseries design of collecting data before, during and after the introduction of an intervention was used. Setting. The Sports Science Institute of South Africa (SSISA): a 5-storey building with a centrally located lift lobby and internal stairwell. Method. Observers were placed unobtrusively on the ground floor, with good visibility of lift/stairwell, to observe ascending movement of students, staff, tenants, visitors and patients 4 hours/day (07h00 - 09h00, 16h00 - 18h00), 4 days/week for 3 weeks. During week 2, motivational signs were displayed on the wall next to the lift and stairs and on the floor leading to the stairwell. In week 3, signage was removed. Factors considered in predicting stair use were gender, phase of intervention, and whether persons were staff/students or visitors. Results. A total of 4 256 person-counts were recorded. Prevalence of stair use increased from 43% before the intervention to 53% during the intervention to 50% after the intervention. Odds of using the stairs during the intervention increased by 45% (odds ratio (OR) 1.45, 95% confidence interval (CI) 1.25 - 1.68) (p<0.00001), were 41% higher for staff/students compared with visitors (p<0.00001) and were 55% greater for women (p<0.00001). These effects did not change significantly after the intervention and stair use remained modestly higher than before the intervention. Conclusion. Signed intervention produced significant increases in stair usage during and after the intervention. These findings support the effectiveness of point-of-decision prompts for changing behaviour, and highlight potential factors influencing the impact of such messages.Item Dental composite materials: highlighting the problem of wear for posterior restorations(South African Dental Association, 2007) Le Roux, Andre Rayne; Lachman, NirushaManufacturers of dental composites promote their products as having ideal wear resistant characteristics. Evaluation of the problems that persist with wear of dental composites is made. Recommendations for further research involving wear resistance of dental composite materials are provided. This article provides a review of English, peer-reviewed literature involving wear resistance of dental composite materials conducted through ScienceDirect and hand searched data bases between 1994 and 2006.Item Wear and flexural strength comparisons of alumina/feldspar resin infiltrated dental composites(South African Dental Association, 2008) Le Roux, Andre Rayne; Lachman, Nirusha; Walker, Mark; Botha, T.Introduction: Incorporating a feldspar chemical bond between alumina filler particles is expected to increase the wear-resistant and flexural strength properties. Aims and Objectives: An investigation was carried out to evaluate the influence of the feldspar chemical bonding between alumina filler particles on wear and flexural strength of experimental alumina/feldspar dental composites. It was hypothesized that wear resistance and flexural strength would be significantly increased with increased feldspar mass. Methods: Alumina was chemically sintered and bonded with 30% and 60% feldspar mass, silanized and infiltrated with UDMA resin to prepare the dental restorative composite material. Results and conclusions: Higher wear-resistant characteristics resulted with increased feldspar mass of up to 60% (p<0.05). Higher flexural strength characteristics resulted as the feldspar mass was increased up to 60% (p>0.05). Feldspar chemical bonding between the alumina particles may improve on the wear-resistance and flexural strength of alumina/ feldspar composites.Item Reducing the alloy thickness of base metal ceramic restorations(Dental Technicians Association of South Africa, 2009) Le Roux, Andre RayneReduction in base metal alloy thickness will permit additional porcelain depth and improved aesthetics but unfortunately little information exists regarding the thickness to which base metal alloys may be reduced in comparison to noble metal alloys for metal ceramic restorations. Even with comparison of noble metal alloys the aesthetic benefits are restricted to improving aesthetics in base metal restoration further, since noble metal alloys are generally regarded as providing superior aesthetics to base metal restorative alloys. Purpose: The objective of this study was to determine whether a significant reduction in thickness could be achieved using a base metal alloy as compared to a noble metal alloy and the thickness to which base metal alloy substructures could safely be reduced while still providing the same resistance to fracture of the porcelain. Material and methods: Tensile strength tests (N) of the modulus of rupture of the porcelain were performed on 40 base metal alloy (Wiron 99, Bego, Germany) and 12 noble metal alloy rectangular specimens (5.8 mm wide and 15.0 mm long) bonded to a standardized 1.0 mm thickness of dentine Creation porcelain. The base metal alloy thickness varied in 0.1mm increments from 0.1 to 0.4 mm. The results were compared to 12 noble metal alloy (Bio Y 81, Argen, South Africa) specimens of recommended minimum thickness (0.3 mm). Data for the results was obtained using a universal tensile testing instrument, which was set to operate at a cross head speed of 0.5mm (Instron Mini 44, Instron corporation U.S.A). The applied force (N) that measured the modulus of rupture of each specimen was printed from a computer connected to the Instron Mini 44 that operated on a 95% level of confidence. Instron Agents (Durban, South Africa) performed the calibration and setting up of the machine prior to testing the specimens. Results: The results indicated a permissible 33.33% reduction in the base metal alloy specimens as compared to the noble metal alloy control specimens. This was deduced from the reduction in alloy thickness of up to 0.2 mm for base metal alloy specimens as compared to the 0.3 mm noble metal alloy specimens. The recommended thickness to which the base metal alloys could be reduced without distortion of the alloy was also 0.2 mm. The one-way ANOVA showed a level of significance of (α=05).